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NPI Code Detail

MEDICARE: MICHELLE DOXSEE PT PC

MEDICARE: MICHELLE DOXSEE PT PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
104-3848958OTHERNYTAX ID

General Provider Information

NPI Number : 1316417702
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHELLE DOXSEE PT PC
Provider Business Mailing Address
First Line : 24 DEWEY ST
Second Line :
City : SAYVILLE
State : NY
Zip : 11782-1302
Country : US
Telephone Number : 631-513-7398
Fax Number :
Provider Business Practice Location Address
First Line : 157 N OCEAN AVE
Second Line :
City : PATCHOGUE
State : NY
Zip : 11772-2016
Country : US
Telephone Number : 631-513-7398
Fax Number :
Authorized Official
Title or Position : OWNER/ PHYSICAL THERAPIST
Name : MICHELLE DOXSEE
Credential : PT
Telephone Number : 631-513-7398
Provider Enumeration Date : 11/28/2018
Last Update Date : 12/20/2019

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